Loading...

Table of Content

    28 August 2024, Volume 19 Issue 04 Previous Issue    Next Issue
    For Selected: Toggle Thumbnails
    Expert forum
    Research progress of Hashimoto thyroiditis
    TIAN Limin, FENG Jing
    2024, 19 (04):  217-223.  DOI: 10.16138/j.1673-6087.2024.04.01
    Abstract ( 1955 )   HTML ( 31 )   PDF (973KB) ( 195 )  

    Hashimoto thyroiditis (HT) is a very common organic autoimmune thyroid disease, and its incidence is increasing year by year. It not only causes hypothyroidism in clinical practice, but also has many connections with a variety of immune diseases, endocrine diseases, rheumatic diseases and thyroid cancer. Although the exact etiology of HT has not been fully clarified, the mainstream treatment is still based on management and alternative treatment of hypothyroidism. However, as the research further deepens, more clinical variants have been gradually discovered, more and more factors have been found to be related to the onset of HT, and new discoveries have been made in treatment methods. This article reviews the research progress on clinical manifestations, pathological features, diagnosis, pathogenesis, relationship with other diseases and treatment of HT.

    References | Related Articles | Metrics
    Original article
    Bioinformatics analysis and identification of cuproptosis characteristic genes for acute pancreatitis by machine learning
    WANG Zhuoxin, HUANG Xinyang, JIN Yixun, WANG Lifu
    2024, 19 (04):  224-230.  DOI: 10.16138/j.1673-6087.2024.04.02
    Abstract ( 162 )   HTML ( 14 )   PDF (1760KB) ( 445 )  

    Objective To discover the characteristic genes of cuproptosis in acute pancreatitis (AP). Methods The expression of cuproptosis-related genes (CRG) in the GSE1943 dataset was extracted and performed differential analysis and immune cell correlation analysis. The different subtypes were classified according to the expression of CRG, and metabolic pathway enrichment was performed using gene set variation analysis. Four machine learning algorithms, including generalized linear models, random forest, support vector machine and extreme gradient boosting were used to screen disease characteristic genes. Results A total of 13 CRG were differentially expressed in AP (P<0.05), and CRG were not only correlated to each other in different degrees, but also had correlation with multiple immune cells (P<0.05). There were four immune-related pathways among the two subtypes obtained by cluster analysis, in which the T-cell receptor signaling pathway was noteworthy. Further analysis revealed significant difference between the two subtypes of multiple T cells (P<0.05). Each machine learning algorithm screened out five characteristic genes, and dihydrolipoamide dehydrogenase (DLD) was obtained as the next target of research. Conclusions CRG-based machine learning and bioinformatics analyses could be used to explore CRG in AP to discover potential biomarkers.

    Figures and Tables | References | Related Articles | Metrics
    Therapeutic effect of theta burst transcranial magnetic stimulation combined with speech training on aphasia after stroke
    ZENG Zhen, LU Chunhua, WANG Kai, ZHANG Qin
    2024, 19 (04):  231-235.  DOI: 10.16138/j.1673-6087.2024.04.03
    Abstract ( 98 )   HTML ( 2 )   PDF (3195KB) ( 596 )  

    Objective Analyzing the clinical treatment efficacy of continuous theta burst stimulation (cTBS), theta burst stimulation (TBS) combined with speech training on post stroke aphasia (PSA). Methods In this study, 90 PSA patients admitted to our hospital from February 2022 to January 2023 were divided into three groups according to different treatment methods, each 30 cases in each group. The basic group was given speech training, the observation group 1 was given cTBS combined speech training, and the observation group 2 was given iTBS combined speech training. The clinical efficacy, western aphasia battery (WAB) score, view naming test results, Boston diagnostic aphasia examination (BDAE) rating, stroke aphasia quality of life scale (SAQOL-39g) score were compared among the three groups. Results The total clinical effective rate (96.67%, 93.33%) in observation group 1 and observation group 2 were higher than that in basic group (60.00%) (P<0.05). After treatment, WAB score and correct number of view naming test in observation group 1 and observation group 2 were higher than those in basic group (P<0.05). The reaction time of view naming test in observation group 1 and observation group 2 were shorter than that in basic group (P<0.05). The improvement degree of BDAE grade in observation group 1 and observation group 2 after treatment were better than that in basic group (P<0.05). The SAQOL-39g score in observation group 1 and observation group 2 after treatment was higher than that in basic group (P<0.05). The total clinical response rate, WAB score after treatment, correct number of view naming tests, response time, improvement effect of BDAE classification, and SAQOL-39g score didn’t show significant difference between observation group 1 and group 2 (P>0.05). Conclusions Both cTBS and iTBS combined speech training can improve aphasia symptoms, view naming ability and quality of life in PSA patients. The clinical efficacy of them is comparable, and both are better than single speech training.

    Figures and Tables | References | Related Articles | Metrics
    Screening and pathway analysis of autophagy-related genes in Alzheimer disease
    SHENG Zhaoqing, LIU Xiaohong
    2024, 19 (04):  236-242.  DOI: 10.16138/j.1673-6087.2024.04.04
    Abstract ( 240 )   HTML ( 0 )   PDF (3101KB) ( 37 )  

    Objective Screen autophagy related genes of Alzheimer disease(AD) based on microarray analysis, conduct pathway analysis and identify key genes in order to explore potential pathogenesis and therapeutic targets. Methods The GSE33000 dataset was downloaded from GEO Database, and the differentially expressed genes of AD were obtained by R software limma package. Autophagy-related genes were downloaded from Human Autophagy Database, Human Autophagy Modulator Database and GeneCard Database, respectively, and the autophagy-related gene set was obtained. The AD autophagy-related genes were obtained through intersecting the differentially expressed genes with the autophagy-related gene set. The R software packages such as org.Hs.eg.db and clusterProfiler were used to perform gene ontology (GO) analysis and Kyoto Encyclopedia of Genes and Genomes (KEGG) analysis, the online software Search Tool for the Retrieval of Interacting Genes (STRING) was used to conduct protein-protein interaction network analysis, and the key genes were predicted based on MCC algorithm. Results A total of 66 autophagy related genes were obtained, of which 41 genes were up-regulated and 25 genes were down-regulated. Gene enrichment analysis showed that cellular components in GO analysis were mainly enriched in phagocytic vesicle membrane, secretory granule membrane, membrane microdomain, late endosome, etc., and molecular functions were mainly enriched in Toll-like receptor binding, ubiquitin-like protein ligase binding, etc., and biological processes were enriched in regulation of autophagy, positive regulation of cellular catabolic process, response to lipopolysaccharide, regulation of inflammatory response, cellular response to external stimulus, etc. In KEGG enrichment analysis, the differentially expressed autophagy-related genes were mainly concentrated in NOD-like receptor signaling pathway, lipid and atherosclerosis, forkhead box protein O(FoxO) signaling pathway, etc. Our research completed the construction of protein-protein interaction (PPI), identified 10 key genes, and screened out that interleukin-6(IL-6) and signal transducer and activator of transcription 3(STAT3) were closely related to AD. Conclusions Ten key autophagy-related genes were obtained in this study, among which IL-6 and STAT3 are more closely related to AD.

    Figures and Tables | References | Related Articles | Metrics
    General practitioners’ current understanding level of obstructive sleep apnea and effect of online training
    JIANG Jie, LI Xiaoli, SU Xiaorong, TONG Jianjing
    2024, 19 (04):  243-248.  DOI: 10.16138/j.1673-6087.2024.04.05
    Abstract ( 94 )   HTML ( 0 )   PDF (1029KB) ( 13 )  

    Objective To investigate general practitioner (GP) current understanding level of obstructive sleep apnea (OSA) and related influencing factors and evaluate the effect of online training on improving their knowledge and confidence levels of identifying and treatment of OSA. Methods Questionnaire surveys were used to evaluate GPs’ knowledge and understanding level of OSA before and after the training, and to analyze potential influencing factors. Results Before the training, the average score of questionnaires of 120 GP was (59.7±18.8) points, and the passing rate was 70.8%. After the training, the average score of questionnaires was increased to (75.0±9.6) points, and the passing rate reached 97.5%. The training significantly improved the GPs’ overall knowledge of OSA (P<0.05). The survey revealed that the training significantly enhanced GPs’ ability to identify high-risk OSA patients (P<0.05). Regarding future training needs, GP mainly expressed a desire to strengthen training in the use of OSA scoring scales, knowledge of non-invasive positive airway pressure (PAP) ventilation therapy, and the management of chronic diseases associated with OSA. Conclusions Online training significantly improved GPs’ knowledge and understanding level of OSA, enhanced their confidence in diagnosis and treatment of OSA. GP should actively participate in continuing education and training related to OSA.

    Figures and Tables | References | Related Articles | Metrics
    Role of heart rate variability in patients with hypertensive cerebral hemorrhage complicated by pulmonary infection after tracheotomy
    CHEN Li, WANG Shaowei, WANG Yunqi
    2024, 19 (04):  249-253.  DOI: 10.16138/j.1673-6087.2024.04.06
    Abstract ( 78 )   HTML ( 6 )   PDF (904KB) ( 59 )  

    Objective To investigate the relationship between heart rate variability (HRV) and pulmonary infection after tracheotomy in patients with hypertensive cerebral hemorrhage (HICH), to provide reference for clinical diagnosis and treatment. Methods The clinical data of 101 HICH patients who underwent tracheotomy from February 2018 to December 2022 were analyzed retrospectively. The patients were divided into infection group and non-infection group according to the complicated pulmonary infection. The general data, inflammatory markers and HRV indexes of the two groups were compared. Pearson correlation was used to analyze the relationship between HRV and pulmonary infection after tracheotomy in HICH patients. Results In 101 patients with HICH, there were 54 cases (53.5%) developed pulmonary infection within 7 d after tracheotomy. There was a statistically significant difference in preoperative Glasgow coma scale (GCS) between the two groups (P<0.05). The cytokines such as interleukin-6 (IL-6), C-reactive protein (CRP), tumor necrosis factor-α (TNF-α) and procalcitonin (PCT) in the infected group were higher than those in the non-infection group. The HRV indexes including the standard deviation of RR interval for all sinus beats within 24 h standard deviation of normal to normal interval (SDNN), 24 h average SDNN (SDANN), the root mean square of successive differences in adjacent RR interval(RMSSD), the percentage of beats with percentage of adjacent normal to normal intervals differing by more than 50 ms(PNN50), high frequency power (HF) low frequency power (LF) were all lower than those of non-infection group (P<0.05). The Pearson correlation test showed that HRV was negatively correlated with IL-6, CRP, TNF-α and PCT (P<0.05). Conclusions HRV in patients with HICH is associated with pulmonary infection after tracheotomy. The lower values of SDNN, SDANN, RMSSD, PNN50, HF, LF suggest an increased risk of pulmonary infection.

    Figures and Tables | References | Related Articles | Metrics
    Case report
    Ultrasound features and clinical manifestations of two cases of thyroid metastatic cancer: pay attention to abnormal thyroid ultrasound spectrum
    LI Yuanyuan, DING Wenbo, JIANG Ziyu, CHEN Xi, LIU Binbin, CHEN Guofang, LIU Chao
    2024, 19 (04):  254-258.  DOI: 10.16138/j.1673-6087.2024.04.07
    Abstract ( 1144 )   HTML ( 15 )   PDF (8859KB) ( 59 )  

    Ultrasonography plays an important role in early screening of thyroid cancer. This article introduced two cases of thyroid metastatic carcinoma secondary to renal clear cell carcinoma and cervical squamous cell carcinoma respectively, analyzed their clinical diagnosis and treatment process, ultrasound characteristics, and prognosis, as well as reviewed the related literature. As atypical thyroid lesions were detected through the ultrasound spectrum in patients with a history of malignant tumors, it should be alert to the possibility of metastatic cancer. Ultrasound-guided core-needle biopsy combined with immunohistochemical testing can help early diagnosis and timely treatment.

    Figures and Tables | References | Related Articles | Metrics
    Review
    Recent advances in diagnosis and treatment of subacute thyroiditis
    LI Yajie, CUI Dai
    2024, 19 (04):  259-263.  DOI: 10.16138/j.1673-6087.2024.04.08
    Abstract ( 1326 )   HTML ( 22 )   PDF (939KB) ( 112 )  

    Subacute thyroiditis (SAT) is a common thyroid inflammatory disease that is frequently prone to misdiagnosis or underdiagnosis, which impact the quality of life for patients adversely. In this review, we summarize the pathogenesis, clinical manifestations, diagnosis, and treatment of SAT, aiming to improve clinician’s understanding of the disease.

    Figures and Tables | References | Related Articles | Metrics
    Research progress on agranulocytosis caused by antithyroid drugs
    TIAN Ruochen, LI Jing
    2024, 19 (04):  264-268.  DOI: 10.16138/j.1673-6087.2024.04.09
    Abstract ( 1545 )   HTML ( 4 )   PDF (970KB) ( 159 )  

    In China, antithyroid drugs are the first choice of treatment for hyperthyroidism. However, their side effects may result in agranulocytosis, which has an insidious onset and requires urgent treatment. Up to date,the mechanisms of agranulocytosis caused by antithyroid drugs is still unclear. Herein, the article reviewed the direct toxic activities, the immune effects, and the genetic susceptibility of antithyroid drugs, which may be helpful to provide better clinical treatment options and improve the prognosis of agranulocytosis caused by the drugs.

    References | Related Articles | Metrics
    Impact of maternal hyperthyroidism during pregnancy on neurological and psychiatric development of offspring
    YANG Ao, ZHANG Peiheng, ZHANG Yang, GAO Ying
    2024, 19 (04):  269-272.  DOI: 10.16138/j.1673-6087.2024.04.10
    Abstract ( 1053 )   HTML ( 1 )   PDF (855KB) ( 13 )  

    Gestational hyperthyroidism can significantly increase health risks to both mother and fetal. However, there are few reports on its impact on the neuropsychological development of offspring. This article reviews the literature related to the effect of hyperthyroidism during pregnancy on brain structure, intelligence quotient (IQ) and neuropsychiatric disorders of offsprings. It was found that hyperthyroidism during pregnancy may be associated with reduced brain volume and cortical gray matter volume, lower IQ, and increase the risk of depression in offspring. However, its’ relationship with other mental and emotional well-being disorder of the offspring is unclear.

    References | Related Articles | Metrics
    Study on efficacy and safety of Dioscorea bublifera L. in treatment of Graves disease
    CUI Yifan, ZHANG Ruixiang, WEI Xiao, LIU Chao
    2024, 19 (04):  273-277.  DOI: 10.16138/j.1673-6087.2024.04.11
    Abstract ( 1378 )   HTML ( 1 )   PDF (955KB) ( 163 )  

    Hyperthyroidism is most common in Graves disease (GD), and traditional antithyroid medicine are often difficult to achieve satisfactory efficacy, and high recurrence rate and long course of treatment are the most prominent problems. Huangyaozi(Dioscorea bublifera L.), a traditional Chinese medicine, has the effect of “Xiao Ying” and has been widely used in the treatment of GD in recent years, but long-term use may cause liver and kidney damage. Therefore, more research on the efficacy and safety of Huangyaozi need to be done in the treatment of GD.

    References | Related Articles | Metrics
    Research progress of the association between intra-pancreatic fat deposition and atherosclerosis
    LI Chenxi, HU Yun, WU Wenjun
    2024, 19 (04):  278-282.  DOI: 10.16138/j.1673-6087.2024.04.12
    Abstract ( 141 )   HTML ( 2 )   PDF (881KB) ( 142 )  

    Intra-pancreatic fat deposition (IPFD) is the most common disease of pancreas in our country. In recent years, there has been increasing evidence that IPFD is closely related to atherosclerosis. However, some studies do not support the correlation between them, which may be affected by differences in study population, atherosclerosis detection methods, and IPFD diagnostic criteria. Therefore, large-sample prospective studies are urgently needed to further clarify the correlation between IPFD and atherosclerosis. The mechanisms involved in correlation between them may be related to inflammation, oxidative stress, hypoadiponectinemia and glucose metabolism. There is currently no specific treatment for IPFD, while weight loss has been shown to significantly reduce the amount of fat deposited in the pancreas. In addition to the treatment of IPFD itself, clinicians should also pay attention to the assessment of the risk of cardiovascular disease in IPFD patients to facilitate early diagnosis and early intervention.

    References | Related Articles | Metrics
    Medical education
    Current situation and improvement strategies of rotation training for non-neurologic residents in department of neurology
    DAI Ruolian, WANG Gang
    2024, 19 (04):  283-288.  DOI: 10.16138/j.1673-6087.2024.04.13
    Abstract ( 113 )   HTML ( 1 )   PDF (905KB) ( 22 )  

    Standardized residency training is an essential stage of medical education after graduation. The neurological diseases are complex and clinical practice requirement is high for non-neurologic professional residents who have different levels and various training requirements. How to achieve the ideal rotation training goal in neurology department remains to be explored so far. Taking the teaching practice of the department of neurology in Renji Hospital, Shanghai Jiao Tong University School of Medicine as an example, the current manuscript provides a useful reference for effectively improving the teaching effect of rotation training of non-neurology residents in the department of neurology.

    References | Related Articles | Metrics